Ram Kumar Shrestha

Social interactions between adult male and infant rhesus monkeys in Nepal

In 1,506 hours of field observations on free-ranging rhesus monkeys in Kathmandu Valley, Nepal, in 1974 and 1975 18 cases of favorable social interactions between adult males and infants were observed. Eleven of these were brief encounters of play or grooming; seven were more extended cases of male care. One of the latter was a complete adoption of a neonatal orphan by a dominant male. This adoption was possessive and restrictive and it resulted in the death of the infant by starvation within three days. A similar adoption involving the same male occurred in 1976 and it also resulted in the death of the infant. Most of the favorable male-infant interactions occurred during the winter and spring when the infants were 6 to 12 months of age. These favorable social interactions involved eight males in six different troops, out of a total of about 48 males in 12 troops in our study population of approximately 600 monkeys. These observations are discussed in light of current sociobiological theories.

Pediatric Central Nervous System Tumors in Nepal: Retrospective Analysis and Literature Review of Low- and Middle-Income Countries.

BACKGROUND Central nervous system (CNS) tumors are the most common cause of cancer-related death in children. Little is known about the demographics and treatment of pediatric brain tumors in low- and middle-income countries (LMICs). METHODS We performed a retrospective chart review of all pediatric patients who presented to the neurosurgical service at Tribhuvan University Teaching Hospital in Kathmandu, Nepal from 2009-2014 and collected information on patients <18 years old who received a diagnosis of a CNS tumor. We analyzed age, gender, clinical presentation, extent of surgical resection, histopathology, and length of hospital stay. We also conducted a literature review using specific terminology to capture studies of pediatric neuro-oncologic epidemiology conducted in LMICs. Study location, length of study, sample size, study type, and occurrence of 4 common pediatric brain tumors were extracted. RESULTS We identified 39 cases of pediatric CNS tumors, with 62.5% observed in male children. We found that male children (median = 13 years) presented later than female children (median = 8 years). The most frequently observed pediatric brain tumor type was ependymoma (17.5%), followed by astrocytoma (15%) and medulloblastoma (15%). Surgical resection was performed for 80% of cases, and gross total resection reported in 62.9% of all surgeries. More than half (54.1%) of patients had symptoms for more than 28 days before seeking treatment. Symptomatic hydrocephalus was noted in 57.1% of children who presented with CNS tumors. The literature review yielded studies from 18 countries. Study length ranged from 2-20 years, and sample sizes varied from 35-1948. Overall, we found more pronounced variation in the relative frequencies of the most common pediatric brain tumors, compared with high-income countries. CONCLUSIONS We present the first operative series of childhood CNS tumors in Nepal. Children often had delayed diagnosis and treatment of a tumor, despite symptoms. More comprehensive data are required to develop improved treatment and management algorithms in the context of a given countrys demographics and medical capabilities for childhood CNS tumors.

Digital soil mapping in the Bara district of Nepal using kriging tool in ArcGIS

Digital soil mapping has been widely used to develop statistical models of the relationships between environmental variables and soil attributes. This study aimed at determining and mapping the spatial distribution of the variability in soil chemical properties of the agricultural floodplain lands of the Bara district in Nepal. The study was carried out in 23 Village Development Committees with 12,516 ha total area, in the southern part of the Bara district. A total of 109 surface soil samples (0 to 15 cm depth) were collected and analyzed for pH, organic matter (OM), nitrogen (N), phosphorus (P, expressed as P2O5), potassium (K, expressed as K2O), zinc (Zn), and boron (B) status. Descriptive statistics showed that most of the measured soil chemical variables (other than pH and P2O5) were skewed and non-normally distributed and logarithmic transformation was then applied. A geostatistical tool, kriging, was used in ArcGIS to interpolate measured values for those variables and several digital map layers were developed based on each soil chemical property. Geostatistical interpolation identified a moderate spatial variability for pH, OM, N, P2O5, and a weak spatial variability for K2O, Zn, and B, depending upon the use of amendments, fertilizing methods, and tillage, along with the inherent characteristics of each variable. Exponential (pH, OM, N, and Zn), Spherical (K2O and B), and Gaussian (P2O5) models were fitted to the semivariograms of the soil variables. These maps allow farmers to assess existing farm soils, thus allowing them to make easier and more efficient management decisions and maintain the sustainability of productivity.

Shifting paradigm in brain abscess management at tertiary care centre in Nepal

Aim: Brain abscess is a challenging clinical entity with substantial high case fatality rates despite significant advances in imaging techniques, laboratory modalities, surgical interventions, and antimicrobial treatment.Otogenic and cardiogenic sources are among the most common. Classic clinical presentation is seen in very few cases only. Burr hole with aspiration works well with good clinical outcomes. Control of primary source in cases of ear infection in the single setting results in good outcomes, reduces for additional surgery, and decreases the duration of hospital stay. Methods: This is prospective observational study conducted at Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal over the period of two and a half years (from September 2014 to March 2017).We analyzed the demographic profile, management strategies and outcome of these cases diagnosed with brain abscess using Microsoft Excel 2007. Results: A total of 51 cases were undertaken for surgical management. There were 35 males and 16 females with the male to female ratio of 2.18:1. The mean age of the study population was 16.76 years with age range from 4 months to 60 years. Otogenic source was the most common. Temporal lobe was the most common abscess location. Headache was the most common clinical presentation and was seen in 86.27% of the study population. All cases were initially managed with burrhole and aspiration of the abscess. Only 3.92% (n = 2) of cases subsequently required surgical excision of the abscess wall. Only 11.76 % (n = 6) of the cases required multiple aspiration. Only 19.61% (n = 10) showed positive culture. Pseudomonas aeruginosa and E. coli were the most common organisms grown. Mortality rate among the study group was 3.92%. Conclusion: With the advent of modern technology in neuroimaging, mortality due to brain abscess has significantly decreased. Joint involvement of the otorhinolaryngology team and efforts in addressing the primary source have further helped in improving outcomes in cases of otogenic brain abscess. Hence, source control is of paramount importance in managing the brain abscess.

Cervical Osteoblastoma: A Rare Primary Spinal Tumor

Osteoblastoma is a rare and benign osteoid producing primary bone tumor that affects mainly the long bones. It makes 5% of spinal tumors, mostly arising within the posterior elements of the spine within the second and 3rd decades of life. We managed an 18 year old patient with osteoblastoma of C6 vertebra. Nepal Journal of Neuroscience 13:51-53, 2016